玻璃酸钠对膝骨关节炎患者疼痛和运动功能的影响

Effect of sodium hyaluronate on pain and motor function in patients with knee osteoarthritis

目的:研究玻璃酸钠(SH)对膝骨关节炎(KOA)患者疼痛和运动功能的影响。方法:将昆明医科大学第一附属医院2017年6月—2018年6月收治的KOA患者38例(62膝)作为研究对象,给与关节腔内注射SH注射液治疗,每周2.5 ml。观察治疗前后患者Lequesne-Mery评分、视觉模拟疼痛评分(VAS)、骨关节炎指数评分(WOMAC)及Opti-knee步态分析。结果:治疗5周后,临床治愈48膝(77.42%),有效6膝(9.68%),无效8膝(12.90%);与治疗前比较,LequesneMery评分、VAS评分、WOMAC评分均降低,差异有统计学意义(P<0.05)。SH治疗单膝KOA患者5周后,Opti-knee步态分析结果提示,与治疗前比较,治疗后单膝KOA患者前后位移最小值增加,差异有统计学意义(P<0.05);Opti-knee 75%步态周期分析结果提示,治疗后患膝的上下位移范围增加,差异有统计学意义(P<0.05)。SH治疗双膝KOA患者5周后,Opti-knee步态分析结果提示,与治疗前比较,治疗后双膝KOA患膝的内外翻最大值和内外翻最小值均增加,内外位移最大值降低,差异有统计学意义(P<0.05);Opti-knee 75%步态周期分析结果提示,治疗后双膝KOA患膝的内外翻增加,上下位移减少,差异有统计学意义(P<0.05);双膝KOA步态分析显示治疗后,双膝KOA患膝的内外翻增加,差异有统计学意义(P<0.05)。结论:关节腔内注射SH治疗5周后,KOA患者疼痛缓解,下肢运动功能得到改善。Opti-knee步态分析能够评价KOA患者的下肢运动功能,可以用于骨关节疾病的长期管理。

Objective:To investigate the effect of sodium hyaluronate(SH)on pain and motor function in patients with knee osteoarthritis(KOA).Methods:A total of 38 patients(62 cases)with KOA admitted to the First Affiliated Hospital of Kunming Medical University from June 2017 to June 2018 were taken as the study subjects.SH injection was injected into the joint cavity at a rate of 2.5 ml per week.Lequesne-Mery score,visual analogue scale(VAS),osteoarthritis index score(WOMAC)and Opti-knee gait analysis were observed before and after treatment.Results:After 5 weeks of treatment,48 cases were cured clinically(77.42%),6 cases were effective(9.68%)and 8 cases were ineffective(12.90%).The Lequesne-Mery score,VAS,and WOMAC score are reduced compared with those before treatment,with statistied signfificance(P<0.05).After SH treatment of single-knee KOA patients for 5 weeks,the results of Opti-knee gait analysis indicated that compared with that before treatment,the minimum value of anterior-posterior displacement of unilateral knee in KOA patients increased,and the difference was statistically significant(P<0.05).The results of Opti-knee 75%gait cycle analysis suggested that the range of up and down displacement of the affected knee increased after treatment,and the difference was statistically significant(P<0.05).After SH treatment of KOA patients in both knees for 5 weeks,the Optiknee gait analysis results indicated that compared with those before treatment,the maximum and minimum values of internal and external inversion of KOA-affected knees in both knees increased after treatment,and the maximum value of internal and external displacement decreased,with statistical significance(P<0.05).The results of Opti-knee 75%gait cycle analysis suggested that after treatment,the internal and external inversion of knee affected in KOA patients increased,and the up and down displacement decreased,with statistical significance(P<0.05).Gait analysis of KOA in both knees showed that after treatment,the internal and external inversion of KOA-affected knees in both knees increased,and the difference was statistically significant(P<0.05).Conclusion:After 5 weeks of intra-articular injection of SH,the KOA patients experience pain relief and improved lower limb motor function.Opti-knee gait analysis can evaluate the lower limb motor function of patients with KOA and can be used for the long-term management of bone and joint diseases.